Cardiology Rosh UPDATED ACTUAL Questions and CORRECT Answers
1. Propranolol Which of the following is a medical treatment for congenital long QT syndrome?
A. Flecainide
B. Propafenone
C. Propranolol
D. Quinidine
2. Heart rate of 160 Which of the following vital signs is considered abnormal in a 2-year-old patient?
beats per minute A. Heart rate of 160 beats per minute
B. Oxygen saturation of 98% on room air
C. Respiratory rate of 26 breaths per minute
D. Systolic blood pressure of 85 mm Hg
3. A patient with In which of the following clinical scenarios is an implantable cardioverter-defibril-
a left ventricu- lator indicated for the prevention of ventricular dysrhythmias and sudden cardiac
lar ejection frac- death?
tion < 35% A. A patient with a left ventricular ejection fraction < 35% and heart failure NYHA
and heart failure Functional Class II or III
NYHA Functional B. A patient with a normal left ventricular ejection fraction and asymptomatic
Class II or III structural heart disease
C. A patient with sustained ventricular tachycardia in the setting of an acute
myocardial infarction
D. A patient with sustained ventricular tachycardia in the setting of hyperkalemia
4. Atrial fibrillation A 65-year-old man presents to the Emergency Department complaining of palpi-
tations for the last week. The palpitations are intermittent, but more severe in the
last 3 hours. His heart rate is 140 and blood pressure is 130/80 mm Hg. His ECG
is shown above. What is the cardiac rhythm shown on the ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Paroxysmal atrial tachycardia
D. Sinus tachycardia
,5. Cardiac trans- A patient with dyspnea and angina fails medication management of his symptoms
plantation with beta-blockers, ACE-inhibitors and calcium channel blockers. He undergoes
complete cardiac evaluation which uncovers the presence of nonobstructive,
end-stage hypertrophic cardiomyopathy. Which of the following is the most ap-
propriate treatment at this point in time?
A. Aggressive diuresis
B. Cardiac transplantation
C. Implantable intracardiac pacing
D. Surgical myectomy
6. Atrioventricular A 10-year-old boy presents to the emergency department complaining of sud-
reentrant den-onset lightheadedness and chest discomfort. His vital signs are T 98.6°F,
tachycardia heart rate 205 beats per minute, respiration rate 30 breaths per minute, and 98%
oxygen saturation. His electrocardiogram is shown above. What is the most likely
diagnosis?
A. Atrial fibrillation
B. Atrial flutter
C. Atrioventricular reentrant tachycardia
D. Ventricular tachycardia
7. Magnesium sul- A 54-year-old man with a history of schizophrenia presents to the ED after a
fate syncopal episode. During your evaluation, he becomes diaphoretic and complains
of dizziness. You are able to feel a radial pulse, and he is alert and talking with you.
His rhythm strip is seen above. Which of the following represents the first-line
treatment of this disorder?
A. Amiodarone
B. Labetalol
, C. Magnesium sulfate
D. Synchronized cardioversion
8. Atrial fibrillation A 74-year-old man is having a preoperative ECG performed. What is your inter-
pretation of his ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Normal sinus rhythm
D. Sinus tachycardia
9. No bridging A 60-year-old man with a history of hypertension and paroxysmal atrial fibrilla-
agent is neces- tion is scheduled to undergo an elective dental extraction. His paroxysmal atrial
sary fibrillation is rate controlled with a beta blocker and he is on chronic anticoag-
ulation with warfarin. Anticoagulation must be discontinued for the procedure.
His medications include metoprolol tartrate, lisinopril and warfarin. In addition to
discontinuing warfarin, which of the following is the most appropriate next step
in management?
A. Bridge with aspirin
B. Bridge with intravenous unfractionated heparin
C. Bridge with low molecular weight heparin
D. No bridging agent is necessary
10. Restrictive car- A 59-year-old woman has furosemide-resistant peripheral edema and ascites.
diomyopathy Her medical history is significant for sarcoidosis. You order an echocardiogram
which reveals increased wall thickness and decreased cavity size of the right
ventricle, enlarged atria and a normal appearing left ventricle. Cardiac MRI shows
no fatty deposition in the ventricular walls. Which of the following is the most likely
diagnosis?
, A. Arrhythmogenic right ventricular cardiomyopathy
B. Dilated cardiomyopathy
C. Hypertrophic cardiomyopathy
D. Restrictive cardiomyopathy
11. Apnea A 1-week-old boy born at term to a 16-year-old primigravida mother without
complications presents to the ED for lethargy. In the ED, his vital signs include
a T 37°C, HR 166 bpm, RR 82/min, and oxygen saturation of 80%. On exam, he
is lethargic with diffuse pulmonary rales and rhonchi, cold extremities, and de-
creased peripheral pulses. Given concern for a ductal-dependent cardiac lesion,
you administer an infusion of prostaglandin E1. Which of the following is a known
adverse reaction of prostaglandin E1 infusion?
A. Apnea
B. Hypertension
C. Hypothermia
D. Thrombocytosis
12. Ventricular An 81-year-old man with 10 years of coronary artery disease presents with chest
tachycardia pain and altered mental status. His ECG shows consecutive, large and wide QRS
complexes. P waves cannot be appreciated. His pulse is 188 bpm. Which of the
following is the most likely diagnosis?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Ventricular tachycardia
13. Tetralogy of Fal- A six-week old infant presents to the ED with his mother who states he has not
lot been feeding well. She notes that he grunts with feeding and that his fingers
seem to turn blue. On physical exam, you observe cyanosis under the tongue and
in the distal extremities. A chest radiograph is seen above. Which of the following
is the likely cause of this infant's presentation?
A. Coarctation of the aorta
1. Propranolol Which of the following is a medical treatment for congenital long QT syndrome?
A. Flecainide
B. Propafenone
C. Propranolol
D. Quinidine
2. Heart rate of 160 Which of the following vital signs is considered abnormal in a 2-year-old patient?
beats per minute A. Heart rate of 160 beats per minute
B. Oxygen saturation of 98% on room air
C. Respiratory rate of 26 breaths per minute
D. Systolic blood pressure of 85 mm Hg
3. A patient with In which of the following clinical scenarios is an implantable cardioverter-defibril-
a left ventricu- lator indicated for the prevention of ventricular dysrhythmias and sudden cardiac
lar ejection frac- death?
tion < 35% A. A patient with a left ventricular ejection fraction < 35% and heart failure NYHA
and heart failure Functional Class II or III
NYHA Functional B. A patient with a normal left ventricular ejection fraction and asymptomatic
Class II or III structural heart disease
C. A patient with sustained ventricular tachycardia in the setting of an acute
myocardial infarction
D. A patient with sustained ventricular tachycardia in the setting of hyperkalemia
4. Atrial fibrillation A 65-year-old man presents to the Emergency Department complaining of palpi-
tations for the last week. The palpitations are intermittent, but more severe in the
last 3 hours. His heart rate is 140 and blood pressure is 130/80 mm Hg. His ECG
is shown above. What is the cardiac rhythm shown on the ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Paroxysmal atrial tachycardia
D. Sinus tachycardia
,5. Cardiac trans- A patient with dyspnea and angina fails medication management of his symptoms
plantation with beta-blockers, ACE-inhibitors and calcium channel blockers. He undergoes
complete cardiac evaluation which uncovers the presence of nonobstructive,
end-stage hypertrophic cardiomyopathy. Which of the following is the most ap-
propriate treatment at this point in time?
A. Aggressive diuresis
B. Cardiac transplantation
C. Implantable intracardiac pacing
D. Surgical myectomy
6. Atrioventricular A 10-year-old boy presents to the emergency department complaining of sud-
reentrant den-onset lightheadedness and chest discomfort. His vital signs are T 98.6°F,
tachycardia heart rate 205 beats per minute, respiration rate 30 breaths per minute, and 98%
oxygen saturation. His electrocardiogram is shown above. What is the most likely
diagnosis?
A. Atrial fibrillation
B. Atrial flutter
C. Atrioventricular reentrant tachycardia
D. Ventricular tachycardia
7. Magnesium sul- A 54-year-old man with a history of schizophrenia presents to the ED after a
fate syncopal episode. During your evaluation, he becomes diaphoretic and complains
of dizziness. You are able to feel a radial pulse, and he is alert and talking with you.
His rhythm strip is seen above. Which of the following represents the first-line
treatment of this disorder?
A. Amiodarone
B. Labetalol
, C. Magnesium sulfate
D. Synchronized cardioversion
8. Atrial fibrillation A 74-year-old man is having a preoperative ECG performed. What is your inter-
pretation of his ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Normal sinus rhythm
D. Sinus tachycardia
9. No bridging A 60-year-old man with a history of hypertension and paroxysmal atrial fibrilla-
agent is neces- tion is scheduled to undergo an elective dental extraction. His paroxysmal atrial
sary fibrillation is rate controlled with a beta blocker and he is on chronic anticoag-
ulation with warfarin. Anticoagulation must be discontinued for the procedure.
His medications include metoprolol tartrate, lisinopril and warfarin. In addition to
discontinuing warfarin, which of the following is the most appropriate next step
in management?
A. Bridge with aspirin
B. Bridge with intravenous unfractionated heparin
C. Bridge with low molecular weight heparin
D. No bridging agent is necessary
10. Restrictive car- A 59-year-old woman has furosemide-resistant peripheral edema and ascites.
diomyopathy Her medical history is significant for sarcoidosis. You order an echocardiogram
which reveals increased wall thickness and decreased cavity size of the right
ventricle, enlarged atria and a normal appearing left ventricle. Cardiac MRI shows
no fatty deposition in the ventricular walls. Which of the following is the most likely
diagnosis?
, A. Arrhythmogenic right ventricular cardiomyopathy
B. Dilated cardiomyopathy
C. Hypertrophic cardiomyopathy
D. Restrictive cardiomyopathy
11. Apnea A 1-week-old boy born at term to a 16-year-old primigravida mother without
complications presents to the ED for lethargy. In the ED, his vital signs include
a T 37°C, HR 166 bpm, RR 82/min, and oxygen saturation of 80%. On exam, he
is lethargic with diffuse pulmonary rales and rhonchi, cold extremities, and de-
creased peripheral pulses. Given concern for a ductal-dependent cardiac lesion,
you administer an infusion of prostaglandin E1. Which of the following is a known
adverse reaction of prostaglandin E1 infusion?
A. Apnea
B. Hypertension
C. Hypothermia
D. Thrombocytosis
12. Ventricular An 81-year-old man with 10 years of coronary artery disease presents with chest
tachycardia pain and altered mental status. His ECG shows consecutive, large and wide QRS
complexes. P waves cannot be appreciated. His pulse is 188 bpm. Which of the
following is the most likely diagnosis?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Ventricular tachycardia
13. Tetralogy of Fal- A six-week old infant presents to the ED with his mother who states he has not
lot been feeding well. She notes that he grunts with feeding and that his fingers
seem to turn blue. On physical exam, you observe cyanosis under the tongue and
in the distal extremities. A chest radiograph is seen above. Which of the following
is the likely cause of this infant's presentation?
A. Coarctation of the aorta
